Reduction In Depressive Symptoms Research Articles

Efficacy and safety of esketamine versus propofol in electroconvulsive therapy for treatment-resistant depression: A randomized, double-blind, controlled, non-inferiority trial

BackgroundElectroconvulsive therapy (ECT) is a commonly used alternative for treatment-resistant depression (TRD). Although esketamine has a rapid pharmacological antidepressant action, it has not been studied as an ECT anesthetic. The objective of this study was to compare the efficacy and safety of esketamine with propofol when both are used as ECT anesthetic agents. MethodsForty patients with TRD were assigned to one of two arms in a double-blind, randomized controlled trial: esketamine or propofol anesthesia for a series of eight ECT sessions. Using a non-inferiority design, the primary outcome was the reduction in HAMD-17 depressive symptoms. The other outcomes were: rates of response and remission, anxiety, suicidal ideation, cognitive function, and adverse events. These were compared in an intention-to-treat analysis. ResultsEsketamine-ECT was non-inferior to propofol-ECT for reducing TRD symptoms after 8 sessions (adjusted Δ = 2.0, 95 % CI: −1.2–5.1). Compared to propofol-ECT, esketamine-ECT also had higher depression response (80 % vs. 70 %; p = .06) and remission (65 % vs. 55 %; p = .11) rates but non-inferiority was not established. In four components of cognitive function (speed of processing, working memory, visual learning, and verbal learning) esketamine-ECT was non-inferior to propofol-ECT. The results for anxiety, suicidal ideation, and adverse events (all p's > .05) were inconclusive. ConclusionEsketamine was non-inferior to propofol when both are used as anesthetics for TRD patients undergoing ECT. Replication studies with larger samples are needed to examine the inconclusive results. Registration numberChiCTR2000033715.

Comparing Email Versus Text Messaging as Delivery Platforms for Supporting Patients With Major Depressive Disorder: Noninferiority Randomized Controlled Trial.

The prevalence of major depressive disorder (MDD) poses significant global health challenges, with available treatments often insufficient in achieving remission for many patients. Digital health technologies, such as SMS text messaging-based cognitive behavioral therapy, offer accessible alternatives but may not reach all individuals. Email communication presents a secure avenue for health communication, yet its effectiveness compared to SMS text messaging in providing mental health support for patients with MDD remains uncertain. This study aims to compare the efficacy of email versus SMS text messaging as delivery platforms for supporting patients with MDD, addressing a critical gap in understanding optimal digital interventions for mental health care. A randomized noninferiority pilot trial was conducted, comparing outcomes for patients receiving 6-week daily supportive messages via email with those receiving messages via SMS text message. This duration corresponds to a minimum of 180 days of message delivery. The supportive messages maintained consistent length and structure across both delivery methods. Participants (N=66) were recruited from the Access 24/7 clinic in Edmonton, Alberta, among those who were diagnosed with MDD. The outcomes were measured at baseline and 6 months after enrollment using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and the World Health Organization Well-Being Index (WHO-5). Most of the participants were females (n=43, 65%), aged between 26 and 40 years (n=34, 55%), had high school education (n=35, 58%), employed (n=33, 50%), and single (n=24, 36%). Again, most participants had had no history of any major physical illness (n=56, 85%) and (n=61, 92%) responded "No" to having a history of admission for treatment of mood disorders. There was no statistically significant difference in the mean changes in PHQ-9, GAD-7, and WHO-5 scores between the email and SMS text messaging groups (mean difference, 95% CI: -1.90, 95% CI -6.53 to 2.74; 5.78, 95% CI -1.94 to 13.50; and 11.85, 95% CI -3.81 to 27.51), respectively. Both supportive modalities showed potential in reducing depressive symptoms and improving quality of life. The study's findings suggest that both email and SMS text messaging interventions have equivalent effectiveness in reducing depression symptoms among individuals with MDD. As digital technology continues to evolve, harnessing the power of multiple digital platforms for mental health interventions can significantly contribute to bridging the existing treatment gaps and improving the overall well-being of individuals with depressive conditions. Further research is needed with a larger sample size to confirm and expand upon these findings. ClinicalTrials.gov NCT04638231; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8552095/.

Strain-specific effects of probiotics on depression and anxiety: a meta-analysis

IntroductionDepression and anxiety are pervasive mental health disorders with substantial global burdens. Probiotics, live microorganisms known for their health benefits, have emerged as a potential therapeutic intervention for these conditions. This systematic review and meta-analysis aim to evaluate the strain-specific effects of probiotics on relieving depressive and anxiety symptoms while elucidating underlying mechanisms.MethodsEMBASE, Cochrane CENTRAL and PubMed/Medline were systematically queried to identify studies released until May 15, 2024. Randomized Controlled Trials (RCTs) that employed standardized assessment tools for depression and anxiety namely Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HAMD), Depression Anxiety Stress Scales (DASS), or Montgomery-Asberg Depression Rating Scale (MADRS) were included.Results12 RCTs involving 707 participants were included. Seven RCTs utilizing the BDI questionnaire demonstrated a significant decrease in depressive symptoms favoring probiotics containing strains such as Lactobacillus acidophilus, Lactobacillus paracasei, Lactobacillus casei, Lactobacillus plantarum, Lactobacillus salivarius, Bifidobacterium bifidum, Bifidobacterium lactis, Bifidobacterium breve, and Bifidobacterium longum (MD: -2.69, CI95%: -4.22/-1.16, p value: 0.00). Conversely, RCTs using HAMD showed a non-significant reduction in depressive symptoms (MD: -1.40, CI95%: -3.29/0.48, p value: 0.14). RCTs employing DASS and MADRS scales also showed no significant differences.ConclusionThis meta-analysis offers valuable insights into the strain-specific effects of probiotics containing Lactobacillus and Bifidobacterium species on depressive and anxiety symptoms. While our findings suggest a significant reduction in depressive symptoms based on the BDI scale favoring probiotics, the lack of significant effects observed on the HAMD, DASS, and MADRS scales underscores the complexity inherent in these conditions. It is imperative to acknowledge the mixed results across different measurement scales, indicating the need for cautious interpretation. Therefore, we advocate for a nuanced understanding of probiotics’ impacts on various dimensions of mood, emphasizing the necessity for further research.

The long-term effect of surf therapy on posttraumatic stress, depression, and anxiety symptomology among current and former australian defence force members - A nonrandomised controlled longitudinal study in a community setting

BackgroundSurf therapy programs have demonstrated engagement among military samples, showing promising concurrent short-term reductions in symptoms of posttraumatic stress disorder, major depressive disorder, and generalised anxiety disorder; however, the long-term retained benefits of such programs have not been studied beyond three months. MethodsThis nonrandomised controlled longitudinal study recruited current and former Australian Defence Force personnel (N = 116) to examine the effect of a ten-session surf therapy program (n = 88) compared to a control group (no intervention; n = 28). Validated self-assessment measures of post-traumatic stress, depression and anxiety symptoms were recorded at pre and post intervention, and at one month, four months, and seven months follow up. ResultsLinear mixed model results reveal statistically significant post-program reductions in symptoms of posttraumatic stress (PCL-M; ß = −11.92, 95% CI [-17.44, −6.36]), depression (MDI; ß = −7.87, 95% CI [-12.35, −3.38]) and anxiety (GAD-7; ß = −4.02, 95% CI [-6.42, −1.57]), which were retained at 7-months follow-up. Clinically significant changes were also observed on all three outcomes. No changes were observed in the control group. Additional statistically significant beneficial effects for each model outcome were recorded for leisure surfing following the program. Most surf therapy participants continued surfing post program, indicating effective lifestyle change. ConclusionsThis is the largest quantitative surf therapy study among adults to date, and the first to follow up seven months post program. It confirms previous surf therapy findings of high engagement and transdiagnostic effects, and provides new clinically relevant knowledge by demonstrating retained beneficial effects regardless of continued surfing post program.

Psychiatric Safety of Semaglutide for Weight Management in People Without Known Major Psychopathology

Obesity is associated with numerous psychosocial complications, making psychiatric safety a consideration for treating people with obesity. Few studies have investigated the psychiatric safety of newly available antiobesity medications. To evaluate the psychiatric safety of subcutaneous semaglutide, 2.4 mg, once weekly in people without known major psychopathology. This post hoc analysis of pooled data from the randomized, double-blind, placebo-controlled, multicenter phase 3a STEP 1, 2, and 3 trials (68 weeks; 2018-2020) and phase 3b STEP 5 trial (104 weeks; 2018-2021) included adults with overweight or obesity; STEP 2 participants also had type 2 diabetes. Trial designs have been published previously. Semaglutide, 2.4 mg, vs placebo. Depressive symptoms and suicidal ideation/behavior were assessed using the Patient Health Questionnaire (PHQ-9) and Columbia-Suicide Severity Rating Scale, respectively. Psychiatric and nervous system disorder adverse events were investigated. This analysis included 3377 participants in the STEP 1, 2, and 3 trials (2360 women [69.6%]; mean [SD] age, 49 [13] years) and 304 participants in STEP 5 (236 women [77.6%]; mean [SD] age, 47 [11] years). In the STEP 1, 2, and 3 trials, mean (SD) baseline PHQ-9 scores for the semaglutide, 2.4 mg, and placebo groups were 2.0 (2.3) and 1.8 (2.3), respectively, indicating no/minimal symptoms of depression. PHQ-9 scores at week 68 were 2.0 (2.9) and 2.4 (3.3), respectively; the estimated treatment difference (95% CI) between groups was -0.56 (-0.81 to -0.32) (P < .001). Participants treated with semaglutide vs placebo were less likely to shift (from baseline to week 68) to a more severe category of PHQ-9 depression (odds ratio, 0.63; 95% CI, 0.50-0.79; P < .001). Based on the Columbia-Suicide Severity Rating Scale, 1% or fewer of participants reported suicidal ideation/behavior during treatment, with no differences between semaglutide, 2.4 mg, and placebo. Psychiatric disorder adverse events were generally balanced between groups. Similar results were observed in STEP 5. The results of this post hoc analysis suggest that treatment with semaglutide, 2.4 mg, did not increase the risk of developing symptoms of depression or suicidal ideation/behavior vs placebo and was associated with a small but statistically significant reduction in depressive symptoms (not considered clinically meaningful). People with obesity should be monitored for mental health concerns so they can receive appropriate support and care. ClinicalTrials.gov Identifiers: STEP 1 (NCT03548935), 2 (NCT03552757), 3 (NCT03611582), and 5 (NCT03693430).

Childhood maltreatment as predictor and moderator for treatment outcome in patients with major depressive disorders treated with metacognitive therapy or behavioral activation

BackgroundChildhood maltreatment (CM) is a risk factor for developing and maintaining depression. It is unclear whether CM influences the effect of treatments for depression. This study examined CM's predictor and moderator effect in Behavioral Activation (BA) and Metacognitive Therapy (MCT). MethodCM was analyzed in a trial comparing a six months treatment program of either BA or MCT for 122 outpatients with major depressive disorder (MDD). Depression was assessed by the Hamilton Rating Scale for Depression (HRSD-24). CM was assessed using the Childhood Trauma Questionnaire (CTQ). ResultsLinear mixed models showed no predictor or moderator effects for the CTQ total score (all p > .58) but revealed a moderator effect for ‘sexual abuse’ on the reduction of depressive symptoms (β = 10.98, SE = 4.48, p = .015) indicating that patients with experiences of childhood sexual abuse benefited more from BA. There also was a predictor effect for ‘physical neglect’ (β = −3.35, SE = 1.70, p = .049): patients without the experience of physical neglect benefited more from treatment regardless of condition. Exploratory analyses indicated no predictor or moderator effects for the onset or persistence of depression, comorbid anxiety disorders or Cluster-C PDs (all p > .28). LimitationsLimitations include small sample sizes for some of the subsamples. ConclusionChildhood sexual abuse seems to moderate treatment effectiveness in a sample of severely affected outpatients with MDD treated with MCT or BA. If confirmed in further trials, a history of sexual abuse might guide the choice between MCT and BA. Trial registrationGerman Clinical Trials Register DRKS-ID: DRKS00011536 (retrospectively registered on February 13, 2017, without changes to the study protocol).

The Effect of Running Training on Improving Classroom Attention in Children with ADHD

Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity, and impulsivity that adversely affect children’s academic performance and behavior in classroom settings. Current ADHD management strategies, primarily pharmacological and behavioral, have limitations, prompting the exploration of alternative interventions. This study investigates the effects of a 12-week structured running training program on improving classroom attention in children with ADHD. Thirty children aged 7 to 12 years participated in a single-group intervention study, with attention, behavior, mood, and physical fitness assessed at baseline, post-intervention, and follow-up. Results showed significant improvements in classroom attention, as evidenced by reduced scores on the Conners’ Teacher Rating Scale-Revised (CTRS-R) and fewer errors on the Continuous Performance Test (CPT). Secondary outcomes indicated notable reductions in hyperactive-impulsive behaviors, anxiety, and depressive symptoms, as well as enhanced physical fitness. These findings suggest that structured running programs may be an effective non-pharmacological intervention for enhancing attention and behavior in children with ADHD. Further research should explore the long-term effects and underlying mechanisms of such interventions and investigate their integration into comprehensive ADHD management plans.

Coping behaviors to reduce anxiety and depressive symptoms: A prospective repeated assessment study

IntroductionHealth institutions provide general recommendations to cope with global crises such as pandemics or geopolitical tensions. However, these recommendations are mainly based on cross-sectional evidence. The preregistered Repeated Assessment of Behaviors and Symptoms in the Population (RABSYPO) study sought to establish prospective longitudinal evidence from a cohort with a demographic distribution similar to that of the Spanish population to provide evidence for developing solid universal recommendations to reduce anxiety and depressive symptoms during times of uncertainty. Material and methodsWe first recruited via social networks a pool of Spanish individuals willing to participate and then randomly selected some within each stratum of age×gender×region×urbanicity to conduct a one-year-long bi-weekly online follow-up about the frequency of ten simple potential coping behaviors as well as anxiety (GAD-7) and depressive symptoms (PHQ-9). Mixed-effects autoregressive moving average models were used to analyze the relationship between past behaviors’ frequency and subsequent symptom changes across the twenty-seven time points. ResultsAmong the 1049 who started the follow-up, 942 completed it and were included in the analyses. Avoiding excessive exposure to distressing news and maintaining a healthy/balanced diet, followed by spending time outdoors and physical exercise, were the coping behaviors most strongly associated with short and long-term reductions of anxiety and depressive symptoms. Engaging in relaxing activities and drinking water to hydrate were only associated with short-term symptom reductions. Socializing was associated with symptom reductions in the long term. ConclusionsThis study provides compelling prospective evidence that adopting a set of simple coping behaviors is associated with small but significant reductions in anxiety and depressive symptoms during times of uncertainty. It also includes a layman's summary of this evidence to help develop general recommendations that serve as universal tools for enhancing mental health and well-being.

A Multi-Center, Open-Label, Single-Arm Study to Investigate the Early Effectiveness of Esketamine Nasal Spray in Patients with Treatment-Resistant Depression Using a Mobile Self-Monitoring Application.

This study assesses the early effectiveness of esketamine nasal spray (ESK) in adults with treatment-resistant depression (TRD) 1 day after the first administration, as monitored through self-assessment via the mobile application, Esketamine Continuing Assessment for Relapse Prevention (EsCARe). In this multi-center, open-label, single-arm study, adults aged 18-65 years diagnosed with TRD after failing at least two antidepressant therapies were enrolled from five tertiary hospitals in South Korea. During the induction period, participants self-administered ESK twice weekly and used the EsCARe app daily to record mood, sleep, and somatic symptoms. Key clinical assessments, the Patient Health Questionnaire-9 (PHQ-9), the Hamilton Depression Rating Scale (HAMD), and the Generalized Anxiety Disorder Scale (GAD-7), were measured at baseline and at weeks 2 and 4. The reliability and validity of EsCARe was assessed. The treatment results indicated significant improvements in depressive and anxiety symptoms, with notable reductions in the PHQ-9 and the GAD-7 by week 2, and the HAMD by week 4. The EsCARe app reliably and validly monitored depressive symptoms and demonstrated a significant reduction in depressive symptoms 1 day after the first administration of ESK. Using ESK, complemented by mobile self-monitoring, effectively reduces the symptoms of TRD early in the treatment course. Integrating mobile health technology into the therapeutic regimen highlights a significant advancement in managing TRD, offering patients and clinicians immediate feedback on treatment efficacy.

Relations between changes in safety behavior, paranoid ideations, cognitive biases, and clinical characteristics of patients with a psychotic disorder over time

BackgroundSafety behaviors, both positive (maladaptive coping behavior) and negative (avoidance behavior), are used by people with paranoid delusions to avoid perceived threats. Safety behaviors contribute to the persistence of paranoid delusions by preventing disconfirmation of threat beliefs and may influence other psychiatric symptoms. This study investigated how changes in safety behaviors are related to changes in paranoid ideation, social anxiety, depression, cognitive biases and self-esteem over time. MethodsThis study included 116 patients diagnosed with a psychotic disorder (DSM-IV) and at least moderate levels of paranoid ideations (GTPS >40).The data were collected as part of a multi-center randomized controlled trial where patients were randomized to VR-CBT (n = 58) or treatment as usual (TAU; n = 58). Assessments were completed at baseline (T0), after three months (T3) and after six months (T6). For all variables, change scores between T0 and T3 and T3 and T6 were calculated and Pearson correlations between change scores were computed. ResultsA decrease in total safety behavior was related to diminished paranoid ideation, social anxiety, and depression. No significant temporal associations were found between changes in safety behavior and changes in cognitive biases and self-esteem. Similar but less robust results were found for respectively negative safety behavior and positive safety behavior. ConclusionDropping safety behavior can be specifically targeted in behavioral interventions. Whereas there appears to be a relation with reduction in anxiety, paranoia, and depressive symptoms, changes in safety behavior do not seem to align with changes in cognitive thinking processes.

Psychometric characteristics of the Hospital Anxiety and Depression Scale in stroke survivors of working age before and after inpatient rehabilitation.

The aim was to examine the psychometric properties of the Hospital Anxiety and Depression Scale (HADS) in cohorts of working age stroke survivors, before and after inpatient rehabilitation. Stroke patients aged 18-66 years registered in the national quality register WebRehab Sweden were included in the study at hospital admission (n = 256), discharge (n = 223), and 1-year follow-up (n = 313). Classical and modern (Rasch) methods were used for psychometric evaluation. The two-factor HADS model measuring anxiety and depression showed better fit than a single factor measuring emotional distress. The instrument's psychometric stability before and after rehabilitation was satisfactory. The anxiety scale showed good psychometric properties, except for item 7, which is not anxiety-specific. Some concerns were observed for the depression items showing weaker discriminant validity, and item 8 performing poorly as a measure of depression. Cronbach's alpha and McDonald's omega coefficients showed satisfactory internal consistency reliability, whereas Rasch person reliability coefficients indicated weaker reliability, especially for the depression scale. Effect size of change between hospital admission and discharge showed a reduction in anxiety and depression symptoms. HADS showed a stable two-factor structure over the rehabilitation period. Patients' perception of items was not affected by the recovery, allowing relevant comparison of HADS scores between different phases of the rehabilitation process. Measures of responsiveness suggest that HADS is sensitive to capturing improvements in emotional distress following rehabilitation interventions. Overall, despite minor psychometric weaknesses, HADS is a suitable instrument for assessing anxiety and depresssion symptoms in stroke patients aged 18-66 years.

Addressing depression and comorbid health conditions through solution-focused brief therapy in an integrated care setting: a randomized clinical trial

BackgroundCo-occurring physical and mental health conditions are common, but effective and sustainable interventions are needed for primary care settings.PurposeOur paper analyzes the effectiveness of a Solution-Focused Brief Therapy (SFBT) intervention for treating depression and co-occurring health conditions in primary care. We hypothesized that individuals receiving the SFBT intervention would have statistically significant reductions in depressive and anxiety symptoms, systolic blood pressure (SBP), hemoglobin A1C (HbA1c), and body mass index (BMI) when compared to those in the control group. Additionally, we hypothesized that the SFBT group would have increased well-being scores compared to the control group.MethodsA randomized clinical trial was conducted at a rural federally qualified health center. Eligible participants scored ≥ 10 on the Patient Health Questionnaire (PHQ-9) and met criteria for co-occurring health conditions (hypertension, obesity, diabetes) evidenced by chart review. SFBT participants (n = 40) received three SFBT interventions over three weeks in addition to treatment as usual (TAU). The control group (n = 40) received TAU over three weeks. Measures included depression (PHQ-9) and anxiety (GAD-7), well-being (Human Flourishing Index), and SFBT scores, along with physical health outcomes (blood pressure, body mass index, and hemoglobin A1c).ResultsOf 80 consented participants, 69 completed all measures and were included in the final analysis. 80% identified as female and the mean age was 38.1 years (SD = 14.5). Most participants were white (72%) followed by Hispanic (15%) and Black (13%). When compared to TAU, SFBT intervention participants had significantly greater reductions in depression (baseline: M = 18.17, SD = 3.97, outcome: M = 9.71, SD = 3.71) and anxiety (baseline: M = 14.69, SD = 4.9, outcome: M = 8.43, SD = 3.79). SFBT intervention participants also had significantly increased well-being scores (baseline: M = 58.37, SD = 16.36, outcome: M = 73.43, SD = 14.70) when compared to TAU. Changes in BMI and blood pressure were not statistically significant.ConclusionThe SFBT intervention demonstrated efficacy in reducing depressive and anxiety symptoms and increasing well-being but did not affect cardio-metabolic parameters over a short period of intervention.Trial RegistrationThe study was pre-registered at ClinicalTrials.gov Identifier: NCT05838222 on 4/20/2023. *M = Mean, SD = Standard deviation.

Relationships of Multidimensional Factors to Diabetes Complications: A Cross-Sectional, Correlational Study.

Diabetes complications are prevalent in people with diabetes, causing considerable individual suffering and increased health costs. However, the relationships of multidimensional, modifiable, and nonmodifiable factors to diabetes complications and the role of diabetes distress have been rarely examined. The aims of this study were to examine the associations of age, sex, knowledge, self-efficacy, self-compassion, resilience, self-esteem, depressive symptoms, diabetes distress, social support, and body mass index with diabetes complications and to investigate the mediating role of diabetes distress. In this cross-sectional, correlational study, data on all study variables were collected from 148 people with diabetes through REDCap in 2023. Multiple regression analysis and the PROCESS macro for SPSS were used to address the aims. Older age and higher levels of diabetes distress were associated with more diabetes complications. Depressive symptoms were associated with diabetes distress; and diabetes distress, but not depressive symptoms, was associated with diabetes complications, controlling for all other variables. Depressive symptoms and diabetes distress were directly or indirectly associated with diabetes complications, and diabetes distress was a mediator in the relationship between depressive symptoms and diabetes complications. Health care providers can target reduction of depressive symptoms and diabetes distress to reduce diabetes complications.

Outcomes of a Self-Management Program for People with Non-Communicable Diseases in the Context of COVID-19.

To evaluate the effectiveness of the online version of the Chronic Disease Self-Management Program (CDSMP) on physical activity and depressive symptoms in individuals with non-communicable diseases (NCDs) in Mexico and Peru during the COVID-19 pandemic. Quasi-experimental study with a non-probability sample of 114 people with NCDs, recruited by invitation in Mexico and by convenience in Peru. The participants were assigned to intervention (n = 85) and control (n = 29) groups. The Personal Health Questionnaire (PHQ-8) and the Physical Activity Scale were used to assess the outcomes. Measurements were taken before and after the intervention. The CDSMP comprises six sessions that take place once per week and last 2.5 h each. The intervention group showed a significant reduction in depressive symptoms and an increase in physical activity (PA) at the end of the program. In contrast, the control group showed no significant improvement in depression and presented a significant decrease in PA.

Facing Your Fears in autistic youth with co-occurring psychiatric conditions: Reductions in symptoms of anxiety and depression

Autistic youth often experience psychiatric complexity, with up to 70 % of youth experiencing at least one mental health issue, and as many as 41 % experiencing two or more issues simultaneously, or complex psychiatric comorbidity. Adapted cognitive behaviour therapy (CBT) for anxiety is effective in reducing anxiety symptoms in autistic youth who have multiple anxiety conditions, as well as other psychiatric conditions (e.g., attention deficit hyperactivity disorder; ADHD). However, few studies have examined the secondary impact of CBT for anxiety on depressive symptoms, despite the high prevalence of depression in autistic youth. Additionally, it is unknown how psychiatric complexity may impact, or moderate, autistic youth’s response to treatment. Fifty-one autistic youth (8–13 years old) participated in an adapted CBT intervention for anxiety (Facing Your Fears). Participants were categorized into one of three groups of increasing psychiatric complexity (Anxiety only; Anxiety + ADHD; and Anxiety + other mental health conditions). Paired sample t-tests and linear mixed models highlighted that autistic youth generally benefitted from CBT for anxiety, as seen in reductions of anxiety and depressive symptoms. Caregivers of youth in all diagnostic groups reported a significant reduction in anxiety symptoms and depression at post-treatment; however, only youth in the Anxiety only group, or those with less psychiatric complexity, reported a reduction in anxiety. Autistic youth did not report any changes in depressive symptoms, regardless of psychiatric complexity. Further study is needed to determine if symptom reductions continue overtime, and whether participating in adapted CBT for anxiety is associated with reductions in other mental health symptoms.

How effective are non-pharmacological interventions for family caregivers? A systematic review with meta-analyses

Informal caregiving is associated with mental disorders and reduced quality of life. The aim of this systematic review was to summarize the results of methodologically high-quality intervention studies on the effectiveness of non-pharmacological interventions on patient-relevant outcomes for family caregivers in Germany. We searched three large scientific literature databases for intervention studies with a control group and a low or moderate risk of bias on the effectiveness of non-pharmacological interventions for family caregivers in Germany. Among 4,376 publications reviewed, 10 intervention studies with good methodological quality were identified. These investigated multi-component interventions or cognitive behavioral therapy for family caregivers of people with dementia (8 studies), stroke (1 study) and with general care dependency (1 study). The control groups received information material as a minimal intervention or usual standard care. Meta-analyses showed a statistically significant slight reduction in depressive symptoms 3-6 months after the start of the study as a result of cognitive behavioral therapy (standardized mean difference -0.27; 95% confidence interval -0.44 - -0.10), but this no longer reached statistical significance after 9-12 months (-0.21; -0.51 - 0.09). Multi-component interventions showed no changes in depressive symptoms either after 3-6 or after 9-12 months (-0.18; -0.40 - 0.03 and -0.14; -0.47 - 0.14, respectively). In contrast, the mental component of quality of life of family caregivers improved statistically significantly in the multi-component intervention groups compared to the control groups: slightly after 3-6 months (0.28; 0.01 - 0.56) and moderately after 9-12 months (0.45; 0.09 - 0.82). The interventions had no effect on the physical component of quality of life. The reduction of depressive symptoms by behavioral therapy interventions for family caregivers appears to be only slight and not sustainable. The mental component of quality of life of people affected may be improved in the longer term by multi-component interventions. Current scientifically examined interventions for informal caregivers do not appear to have a sufficient and sustainable effect. Greater effects could possibly be achieved through more elaborate behavioral approaches, but also structural preventive measures.

Effects of virtual reality-based cognitive training for adolescents with depressive episodes: A pilot randomized controlled study

Cognitive impairment is a common symptom in depression, yet few intervention strategies target adolescents. This study investigated the effects of an attention and working memory cognitive training system based on virtual reality (VRCT) in adolescents with mild to moderate depressive episodes. Adolescents with depression were randomized into a VR training group (VRG, n = 47) or a waitlist control group (WT, n = 46). The VR training consisted of three 10-min tasks per session, conducted three sessions per week for 20 sessions over 7 weeks. Forty-four healthy adolescents participated as a comparison group for baseline cognitive assessment. Cognitive functions and depressive symptoms were assessed using the Das-Naglieri cognitive assessment system, driven by the Planning, Attention, Simultaneous, and Successive (PASS) processing theory, and the Hamilton Depression Rating Scale-24 at pre- and post-intervention. Baseline results indicated significantly lower cognitive scores in patients compared to healthy adolescents. Post-intervention, the VRG demonstrated significant improvements in all four cognitive scales (effect sizes 0.56 to 0.76) and a significant reduction in depressive symptoms compared to the WT. These findings suggest that VRCT holds potential for improving cognitive impairments and alleviating depressive symptoms in adolescents with depression. Further large-scale and follow-up studies are necessary to confirm long-term benefits.

Alternative therapeutic approach for anxiety and depression: Review on the use of different essential oils

Depression, a prevalent psychiatric condition, affects over 300 million people worldwide, according to the World Health Organization. Despite the effectiveness of conventional treatments such as antidepressants and psychotherapy, many patients do not respond adequately, sparking interest in alternative therapies. The objective of this review is to explore the therapeutic potential of essential oils from lavender, bergamot, Sicilian lemon, clove, ylang-ylang, chamomile, and lemon balm in the treatment of anxiety and depression, based on extensive bibliographic research from databases like SciELO, PubMed, SciFinder, and Elsevier. The results show that lavender essential oil significantly reduces depression symptoms through inhalation and topical application. Bergamot, clove, and Sicilian lemon oils also demonstrated antidepressant properties. However, ylang-ylang oil did not show significant results in reducing depressive behaviors. It is important to note that further research is needed to understand their mechanisms of action and strengthen the evidence base. While alternative therapies offer benefits, they should not replace established pharmacological treatments.

Level of Psycoeducation Effectiveness on Adaptation Fracture Patients at Pirngadi Hospital Medan City

&lt;div&gt;&lt;table cellspacing="0" cellpadding="0" align="left"&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left" valign="top"&gt;&lt;p&gt;&lt;em&gt;Two thirds of injury cases in developing countries, including Indonesia, are still a major public health problem in all countries. In 2020 there were 152.256 injury cases in Indonesia (17.8%). Fractures cause a variety of negative effects, including psychological, social, and spiritual. A report from the Department of Health shows that 15 percent of fracture sufferers experience emotional stress and even depression. Psychological education helps in the treatment and reduction of depressive symptoms, which are part of the psychological response to disability. This research is to find out how well psychoeducation helps fracture patients adapt at Pirngadi Hospital, Medan City. This type of research is quasi-experimental with a pre-test-post-test design with control group. This research was carried out at Pirngadi Hospital, Medan City from 21 July to 23 August 2023. The study population included 67 patients who experienced grade 2 and 3 fractures. The sampling technique is non-probability sampling. The number of samples in this study was 16 people for the control group and 16 people for the treatment group. The research instrument has been tested for validity and reliability. Univariate analysis to describe research variables, while bivariate analysis with dependent t test to determine the mean differences in the treatment group before and after being given psychoeducation and in the control group at pre-test and post-test. The results of the study showed that there was a difference in the average adaptation of fracture patients who were given psychoeducational intervention compared to the group of patients who were not given intervention with p value = 0.000; 95% CI &amp;lt; alpha = 0.05. &lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt; &lt;/em&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt;&lt;/div&gt;&lt;strong&gt;&lt;em&gt;Keywords: Frakture, Injury Patient, Psychoeducation&lt;/em&gt;&lt;/strong&gt;

Omega-3 Polyunsaturated Fatty Acids in Depression.

Omega-3 polyunsaturated fatty acids have received considerable attention in the field of mental health, in particular regarding the treatment of depression. This review presents an overview of current research on the role of omega-3 fatty acids in the prevention and treatment of depressive disorders. The existing body of evidence demonstrates that omega-3 fatty acids, in particular eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have antidepressant effects that can be attributed to their modulation of neuroinflammation, neurotransmitter function, and neuroplasticity. Nevertheless, clinical trials of omega-3 supplementation have yielded inconsistent results. Some studies have demonstrated significant reductions in depressive symptoms following omega-3 treatment, whereas others have shown minimal to no beneficial impact. A range of factors, encompassing dosage, the ratio of EPA to DHA, and baseline nutritional status, have been identified as having a potential impact on the noted results. Furthermore, it has been suggested that omega-3 fatty acids may act as an adjunctive treatment for those undergoing antidepressant treatment. Notwithstanding these encouraging findings, discrepancies in study designs and variability in individual responses underscore the necessity of further research in order to establish uniform, standardized guidelines for the use of omega-3 fatty acids in the management of depressive disorders.